Provider Demographics
NPI:1114951399
Name:STUMBAUGH, TAMMY LYNN (MS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:STUMBAUGH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1025
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3801
Mailing Address - Country:US
Mailing Address - Phone:808-945-2282
Mailing Address - Fax:808-945-2239
Practice Address - Street 1:1600 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1025
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3801
Practice Address - Country:US
Practice Address - Phone:808-945-2282
Practice Address - Fax:808-945-2239
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS